Splenosis: a great mimicker of neoplastic disease

Our plain-English summary of Splenosis: a great mimicker of neoplastic disease, by Y.K. Tandon, C.P. Coppa, A.S. Purysko (Abdominal Radiology, 2018).

The study

• Authors: Y.K. Tandon, C.P. Coppa, A.S. Purysko
• Journal: Abdominal Radiology
• Published: 2018;43(11):3054-3059
• Type of article: Case report
• Cited by: 36 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Splenosis is a benign condition that can occur after splenic trauma or after surgery involving the spleen. These splenic implants are most often seen within the abdominal and pelvic cavities. On imaging, splenosis can be confused with multiple additional entities including metastatic disease, peritoneal carcinomatosis, peritoneal mesothelioma, abdominal lymphoma, renal cancer, hepatic adenomas, or endometriosis depending on its distribution. In all patients with history of splenic surgery or trauma, splenosis should be on the differential diagnosis of soft tissue nodules in the abdomen and pelvis, especially in the absence of systemic symptoms, to avoid unnecessary biopsy, chemotherapy, or surgery.

In plain English

This Cleveland Clinic imaging article reported three cases of splenosis. Splenosis is a benign condition in which spleen tissue implants elsewhere after the spleen is injured or operated on. The article does not study asbestos; peritoneal mesothelioma appears only among diseases splenosis can resemble on scans. In the first case, a 67-year-old man had a 5.2 by 2.9 cm pelvic mass on CT. Biopsy was recommended until his history showed a splenectomy at 18 after a car accident; a sulfur colloid scan then confirmed spleen tissue. In the second, a 53-year-old man with prostate cancer had a pelvic lesion judged to be spleen tissue, confirmed during prostate surgery. In the third, a 65-year-old man with a past splenectomy and renal cell carcinoma had nodules scattered through the abdominal cavity. These were presumed splenosis, and continued surveillance rather than biopsy was recommended. The authors concluded that in patients with past splenic surgery or trauma, splenosis should be considered for abdominal and pelvic soft tissue nodules, especially without systemic symptoms, to avoid unnecessary biopsy, chemotherapy, or surgery.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (three cases) with discussion of the literature
• Who was studied: Three men, aged 67, 53 and 65, imaged at the Cleveland Clinic (Cleveland, Ohio, USA); dates not given
• Exposure: No asbestos exposure was studied. The cases concerned spleen tissue implants after past splenic trauma or splenectomy, for example after a car accident.
• Main results:
  • Case 1 (67-year-old man): CT showed a 5.2 by 2.9 cm pelvic soft tissue mass between the bladder and rectum.
  • Case 1: after his past splenectomy was found, a sulfur colloid scan was recommended instead of biopsy, and the scan confirmed ectopic splenic tissue.
  • Case 2 (53-year-old man with prostate cancer): a 3.5 by 2.1 cm lesion next to the left seminal vesicle was judged to be splenic tissue rather than malignancy, and this was confirmed at prostatectomy.
  • Case 3 (65-year-old man with past splenectomy and renal cell carcinoma): multiple nodules throughout the peritoneal cavity were presumed to be splenosis, and continued surveillance rather than biopsy was recommended. The article does not report the results of any later surveillance.
• The authors' conclusion: The authors concluded that in all patients with a history of splenic surgery or trauma, splenosis should be considered as a possible cause of soft tissue nodules in the abdomen and pelvis, especially without systemic symptoms, to avoid unnecessary biopsy, chemotherapy, or surgery.

Topics

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Differential Diagnosis, Biopsy, Chemotherapy.

Related studies

• Intrathoracic splenosis - lesson learned: a case report — L. Tulinský, P. Ihnát, et al. (2016)
• Extensive intrathoracic and intraperitoneal splenosis mimicking mesothelioma: a case report — B. Föh, M.M. Sieren, et al. (2022)
• Thoracic splenosis diagnosed by fine-needle aspiration cytology: a case report — S. Syed, P. Zaharopoulos (2001)
• Neoplastic Pericardial Disease — J.J. Maleszewski, N.S. Anavekar (2017)
• Multimodality imaging of common and uncommon peritoneal diseases: a review for radiologists — R.A. Vicens, M. Patnana, et al. (2015)
• Experience with asbestos disease and its control in Great Britain's naval dockyards — P.G. Harries (1976)

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